Pandora's Helix

Five

Ann Miles had been holding a call from Eve Sayers. Neef put a hand to his forehead and made a face when she told him; he had forgotten that the journalist was due to call back today. He nodded to Ann and picked up the receiver.

“Well, do I get to come and visit him?” asked Eve. She sounded anxious.

“To be quite honest, Eve,” confessed Neef. “I haven’t had time to think about it. We’re about to start out on a trial of the new therapy I mentioned. We just got final permission this afternoon.”

“Sounds exciting. So, what do you think?” asked Eve, returning to her original question.

“There would be certain conditions.”

“Like what?”

“I’d need your assurance that you were coming here as a private individual, not a journalist.”

“You have it.”

“And if you start visiting Neil, you don’t stop.”

“I don’t understand. What do you mean?”

“It’s not unusual for people to want to visit sick children, especially the terminally ill but they want to do it on their own terms; they want to come when it suits them and not when it doesn’t.”

“I’m not one of them,” said Eve.

“I didn’t imagine you were but if Neil forms an attachment to you, as well he might considering how well you two got on the first time, you would have to respect it, even when his condition starts to worsen. You will have to be around for him, however distressing you personally might find it.”

This time there was a long pause.

Neef said, “I’m glad you’re taking time to consider.”

“I suppose I hadn’t thought that one right through,” said Eve.

“Think about it on your own for a bit,” said Neef. “Call me back tomorrow. Better still... come to lunch with me on Sunday?”

“Lunch?”

Neef had voiced the invitation on the spur of the moment and was suddenly filled with doubts. He felt slightly embarrassed and more than a little vulnerable. It was however, too late to change his mind. He explained, “One of my colleagues, Frank MacSween and his wife have asked me to lunch on Sunday. They said I should bring a friend if I had any left after you and your paper had finished with me. They’ll be most impressed if I turn up with the assassinating journalist in question.”

“I see,” said Eve. “Tangled web and all that. All right, I’ll come.”

Neef wrote down her address and said he would pick her up at twelve thirty.

“What does your colleague do?” asked Eve as an afterthought.

“He’s a pathologist,” replied Neef.

Neef put down the phone and wondered for a moment what he had done. He couldn’t remember the last time he had turned up at a function other than on his own. Certainly not since Elaine’s death. Four years was a long time. Depending on who else was at the MacSweens on Sunday, tongues might start wagging. Did it matter? He supposed not. Apart from anything else he had only asked Eve along as a sort of riposte to Frank’s joke about having no friends, he reassured himself.

On Friday morning Neef held his weekly meeting with his unit medical and senior nursing staff. He was able to give them the good news that his application for the latest American anti-cancer drug, Antivulon, had been approved after further consideration by the Pharmacy sub-committee. Tim Heaton had kept his word; the unspoken quid pro quo had been honoured. The news had come by way of an internal memo from Heaton’s office; it had arrived just before the meeting.

“The question now, of course, is who do we treat?” said Neef. “Our problem is compounded by the fact that Menogen will be starting their trial on Monday and I’d like your views on candidates for Gene Therapy as well.”

“I suggest that John Martin be changed to Antivulon as soon as possible,” said Tony Samuels.

“He hasn’t settled on standard chemotherapy then?” asked Neef.

“No sir, he’s had a pretty unpleasant week all round. Things just aren’t getting any better for him.”

“And we’ve still not been able to start him on radiotherapy,” added Lawrence Fielding.

“Then he sounds like our first Antivulon patient,” agreed Neef. “I called the Pharmacy department as soon as I got the go-ahead. There’s no local agency handling the drug so they’ll have to order it directly from the States. They’re FAXing the request.”

“What about Thomas Downy, sir?” asked John Duncan. “Now that Mr Beavis has decided against surgical intervention.”

“I’m marking Thomas down for Gene Therapy,” said Neef. “Dr Pereira thinks he’s a good candidate, always providing we can reach the tumour with a needle. I think we can. I’ve already had a word with his parents so we have their permission but I’ve still to arrange a surgical team.”

“I see sir.”

“Some of our kids are doing really well on the regimen they’re on at the moment,” said Lawrence Fielding. “I suggest we leave them out of the reckoning and concentrate on the ones that aren’t doing so well.”

“That’s imperative in the case of Gene Therapy candidates,” said Neef. “Our open license dictates we confine therapy to those with very poor prognoses. So let’s eliminate our success stories from the list of potential candidates.”

Fielding read out a list of names he thought should be excluded from consideration, asking for occasional confirmation from Kate Morse.

After a further half hour’s discussion and with eight children assigned to either Gene Therapy or Antivulon treatment, the group reached a stage where there were just two patients left for consideration, Jane Lees and Neil Benson.

“I hate saying this about any child,” said Neef, “but I fear Jane may be a lost cause. The tumours are just so wide spread in her lungs.”

“She’s been fading fast since she was admitted,” said Kate Morse. “I think maybe her pneumonia left her debilitated but she has very little in the way of fighting spirit and that’s working against her.”

“She would be totally unsuitable for Gene Therapy according to Max Pereira but I think I would be in favour of giving her Antivulon,” said Neef.

“Nothing to lose,” said John Duncan.

“Maybe everything to gain,” added Tony Samuels.

“Then we’re agreed?”

There were nods all round.

“That just leaves Neil,” said Neef. “The bravest of hearts in the smallest of bodies. Is he still in remission?”

“No increase in tumour size,” replied Fielding. “He’s still on the plateau.”

“Then we let well alone for the moment,” said Neef with an air of finality.

“And when it starts to grow again?”

“We’ll cross that bridge when we come to it.”

Frank MacSween had gone off to a pathologists’ meeting up in University College Hospital leaving Chief Medical Laboratory Scientific Officer, Charlie Morse in charge of the path lab. Knowing that the PM suite would not be in use for the next few hours, Morse decided that this would be a good time to get the faulty extractor fan above table four fixed. He called Hospital Maintenance and asked for the electrical foreman, Doug Cooper.

“Any chance of one of your lads fixing a faulty fan in the PM room?” Morse asked.

“Not occupied is it?”

“No, nor liable to be for some time. There’s some kind of meeting on up at Uni College.”

“In that case and seeing it’s you asking, Charlie, I’ll come myself,” said Cooper.

Cooper, a jovial looking man with red hair and freckles was there within five minutes. He wore a royal blue boiler suit, open to the waist, exposing a Fair Isle pattern sweater with a hole in it; he carried a silver metal tool-box. He chatted with the young girl technician at Reception while he waited for Morse to appear. He was telling her that his daughter was about to start out soon on a nursing career, when Morse finally came through the swing doors. “Maybe she’ll be a unit sister one day, like this man’s wife,” he smiled.

“Good of you to come so quickly, Doug,” said Morse. “Come and I’ll show you the problem.”

Morse unlocked the PM suite and clicked on the lights. They stuttered slowly into life and settled down to a constant background hum.

“This place gives me the creeps,” said Cooper as he entered. The uncertainty showed in his step.

“It’s all in the mind,” smiled Morse.

“I suppose you’re right but you can’t help but think what happens on these tables, can you?” Cooper paused by the first one to run his fingers lightly along one of the drainage channels. His eyes strayed to a bank of heavy clasped doors along the far wall. “Is that where you keep them?” he asked, his voice falling to a whisper.

“That’s the body vault,” said Morse. “But nobody’s going to jump out at you, I promise.”

They had reached table four and Morse pointed up at the fan. “That’s the offender,” he said. “It sounds like it’s fouling something and I think there’s a bad electrical connection. It keeps starting and stopping. It annoys the boss; this is his favourite table.”

Cooper gave a look that suggested he couldn’t imagine anyone having such a favourite object. “Do you have step ladders down here?” he asked.

“No, but I’ll get you some. You could always stand on the table if you like?”

Cooper looked down at the metal table with distaste all over his face. “I’d rather not if it’s all the same to you.”

“OK,” smiled Morse. “Won’t be long.”

Cooper looked uncertain at being left alone but managed to smile manfully. He started whistling loudly as soon as Morse was out of sight. He favoured a Beatles selection.

Charlie Morse returned with a small pair of aluminium step ladders and positioned them beside the table. “There you go.”

Cooper took a screw driver from his box and climbed the steps to begin undoing the grill over the fan housing. When he had removed the last of four retaining screws, the grill still refused to budge. He tried using the flat end of the screw driver as a jemmy but found it difficult to insert far enough to get any purchase.

“Problems?” asked Morse.

“Can’t budge it,” replied Cooper.

“Maybe if I supported the grill you could use a hammer on the end of your screwdriver?” suggested Morse.

“Worth a try,” replied Cooper, now grunting with the effort of working with his hands over his head.

Morse found a small ball-pein hammer in Cooper’s box and got up on to the PM table to pass it to him. He stretched up to support the grill; he didn’t want it falling down on the table should it break free. Cooper started tapping with the hammer and managed to insert the end of the screwdriver far enough for him to start using it as a lever. He no longer required the hammer and passed it to Morse who accepted it and stooped down to lay it on the table. As he straightened up to restore support to the grill, he was just too late. The grill, complete with its dirty cowling broke free and fell away, showering both of them with all manner of dirt and dust. As they had been looking upwards at the time, they got it full in the face and started coughing and spluttering. There was so much dirt in his eyes that Morse had to kneel down blindly to find the edge of the table to help him find his way to the floor.

“Sorry about that, Charlie,” said Cooper when he had finally stooped coughing and descended the ladders to join him. “Bloody thing hasn’t been off in years.”

When Cooper had stopped apologising, he burst out laughing and said, “We look like something out of the Black and White Minstrel Show. Remember that?”

Cooper gave an impromptu rendition of Swannee River.

“Very funny. Let’s get cleaned up and then you can get on with it.”

Morse led the way to the changing room adjoining the PM suite and elbowed on the taps. He allowed Cooper to wash first. While Cooper was drying his hands and face he looked at his surroundings. The rows of plastic aprons and Wellington boots put his imagination into overdrive again. His attention was caught by a blackboard on the wall. There were two names written up on it in pale blue chalk.

“Are these the next customers?” he asked Morse.

“Yes,” replied Morse.

“I don’t understand how anyone can do this for a living,” said Cooper, shaking his head. “What a way to spend your life, cutting up dead people.”

“They probably don’t see it that way,” said Morse.

“It’s what they do, isn’t it?”

“It’s what goes on in your head that’s important,” said Morse. “Have you ever heard the story about the three stone masons?”

Cooper shook his head.

“When they were asked what they were doing, one replied, ‘I’m earning a living.’ The second replied, ‘I’m building a wall.’ But the third answered, ‘I’m building a cathedral.’ They were all doing the same job; they just saw it differently. The pathologists here investigate the causes of death and the effects of disease and injury to the body so that medical science can learn from it and hopefully improve things for the rest of us.”

“If you say so, Charlie,” said Cooper with a sigh. “Let’s get back to that fan. The sooner I’m out of here the better.”

Neef woke early on Sunday morning before even Dolly had given him his regular alarm call of a paw in the face. He lay thinking about whether it had been a good idea to have invited Eve Sayers along to the MacSweens before deciding finally that as he’d already done it, there was no point in wondering. He got up and filled the kettle to make coffee before going off in search of Dolly. She tended to sleep in different places around the house. He found her curled up on the settee. There had been a time when Neef had tried to discourage Dolly from sleeping on the furniture but in the end they had come to an arrangement; Dolly slept where she liked. Over the past couple of years Neef had accumulated a wide range of implements for removing cat hair from his clothes.

Dolly opened one eye when Neef stroked her but, seeing it was only him, closed it again. Neef smiled and went off to fill her bowl before making his own coffee and returning to sit in his favourite chair, looking out at the garden. Maybe he’d cut the grass before he went out to lunch. He liked having a garden but didn’t enjoy gardening. He did what was necessary to keep it tidy but that was as far as it went. Luckily there were no neighbours for him to offend when the grass sometimes got more than a little too high. By the same token he could make as much noise as he liked. He could begin cutting grass with a petrol-engined mower at eight on a Sunday morning if the notion took him and it did.

When the mowing was done, Neef changed to using a petrol powered strimmer to attack the long grass where the mower couldn’t reach before finally changing to manual shears to keep the encroaching shrubbery at bay. He was sweating freely by the time he came back indoors and showered leisurely before making himself two slices of toast, two boiled eggs and some more coffee. After this he set about tidying up the house. He usually did this on Sunday morning.

Neef dressed casually in navy slacks and a denim shirt with a cream coloured Arran sweater on top. He picked up Eve at twelve thirty as arranged and discovered that she lived in a well-appointed third floor apartment of a modern block on Durham Road. The walls were plain white with occasional splashes of colour provided by a series of modern prints which Neef found difficult to decipher as anything other than splashes of colour. He was no great fan of modern art. There were two black leather sofas facing each other on opposite sides of an Adam style fireplace, hosting a living flame gas fire and each had a small table alongside with identical ceramic lamps standing on them. The main carpet was cream and there were three strategically placed rugs of North African origin. Neef guessed at Tunisia because of the blue element in them. French windows led out to a small balcony where four slow-growing conifers braved the elements from terra cotta pots.

“Would you like a drink before we go and spring the joke?” asked Eve. She had said it with a smile but Neef imagined he detected a slight edge in her voice.

“I’m sorry,” he said, “I shouldn’t have put it the way I did. It was clumsy of me. I didn’t mean to infer that I was only asking you to lunch because I...” Neef paused then said, “I’m being even clumsier...”

Eve nodded with an amused look on her face. “I’d quit if I were you.”

Neef nodded. “Sorry.”

“Are you sure you still want me to come?”

Neef nodded. “I’m certain.” He was thinking how attractive she looked.

“About that drink?”

“I’ll wait.”

The MacSweens occupied the lower half of a red sandstone mansion in Collingbourne Crescent. They had lived there all their married life, some twenty three years and photographs of their family’s progress over that time occupied most flat surfaces in the comfortable drawing room that Neef and Eve were shown into. Neef liked the room; he knew it well. He had spent many happy evenings there since coming to St George’s. He had great affection for Frank and Betty; they had been particularly kind to him when he had first arrived at St George’s and hadn’t known a soul.

“You’re a dark horse,” said Frank MacSween to Neef, when he was introduced to Eve.

“Hello, my dear,” said Betty, smiling at Eve and taking her hand. “So glad you could come.”

Neef thought it typical of Betty. She always spotted who needed looking after and made it her business to put people at their ease. She was kindness itself.

“Eve is a journalist,” said Neef. “In fact, she’s the journalist.”

Frank MacSween looked surprised. “You can’t mean the Torrance story?” he asked.

“I’m afraid so,” said Eve.

“Then you and I have a lot in common,” said Frank, recovering his composure.

“How so?” asked Eve, “I thought you were a pathologist.”

“We both perform autopsies, only I tend to confine my activities to the dead.”

“And that will be enough of that, Frank MacSween,” scolded Betty. “This young lady is our guest and she is very welcome as any friend of Michael’s always is.”

“Thank you,” said Eve.

Despite the fact that Eve and Betty seemed totally different in terms of personality, they seemed to get on like a house on fire. It pleased Neef.

There were four other lunch guests, Kate and Charlie Morse, and Frank and Betty’s daughter, Clare who was there with her husband Keith. They had their baby son, Nigel with them. The baby slept through lunch in a Moses basket placed on the bench seat in front of the bay window. Kate Morse gave Neef a knowing look when she realised who his lunch date was but that was a far as it went. She was polite if not overly friendly towards Eve.

After lunch, Kate and Charlie fell to conversation with Clare and Keith about the state of their garden. They had discovered during the course of lunch that Keith ran a landscape gardening business up in Yorkshire. They were now discussing ornamental pools and whether plastic liners or pre-formed fibreglass was best. Eve disappeared into the kitchen with Betty, leaving Frank and Neef with each other for company.

“Fancy a walk round the garden?” asked Frank.

“If you like,” replied Neef.

The MacSweens had a large garden with well tended lawns and shrubbery. Betty looked after it. Gardening was one of her passions. Frank acted as a labourer when necessary but took no part in the planning apart from one feature which he was particularly proud of. He showed Neef a tunnel he had created in a dense beech hedge leading to a small circular clearing deep inside the hedge run. “Do you know what that is?” he asked Neef.

Neef shook his head. “No idea,” he said.

“That is going to be my grandson’s gang hut.”

Neef smiled. “Ideal,” he agreed.

“I’m looking forward to the day he discovers it,” said Frank. “I won’t ever tell him I deliberately made it. I’ve also plans for a tree house for him. It’ll go in the chestnut up there.” He pointed to the friendly looking tree at the top of the garden with lots of spreading horizontal branches. “I’ve started collecting the boards and I’ve managed to lay my hands on a rope ladder.”

“It sounds like you’ve got it all worked out,” said Neef.

“I have. Having children gives you the chance to turn back the clock and relive part of your life all over again. See things through their eyes, things you’d forgotten. Having grandchildren means the same all over again only it will be more relaxed. I’m looking forward to it.”

Neef nodded. He was thinking of Elaine.

“That’s a good looking young lady you’ve got there,” said MacSween as they continued their walk. “How come you’re walking out with the enemy?”

“I wouldn’t put it quite like that,” said Neef. He told MacSween of the series of events.

“So that’s why the story in the paper wasn’t as bad as I expected,” said MacSween. “Ms Sayers was pulling her punches.”

“I think if it hadn’t been for her editor’s insistence, she might have pulled the story altogether,” said Neef.

“So you’re going to let her visit the boy in your unit?”

“I think so. Neil liked her, I could tell. He’s got nobody else.”

MacSween gave a non committal grunt.

“You don’t think it’s a good idea, do you?” said Neef.

“It’s not my decision,” said MacSween, “But have you considered the possibility that Ms Sayers may have sacrificed the impact of one tear-jerker story in order to get several? The inside story of a children’s cancer ward. There’s a lot of journalistic mileage in that one. Second hand emotion by the barrel. Enough tears to fill a river.”

“Kate has expressed similar doubts,” admitted Neef, “but Eve has promised me that she will not be working when she’s in the unit. Neil is having a remission right now; his tumour has stopped growing. I think if he develops a relationship with Eve, it might help him. We can’t quantify the importance of mental state in terms of prophylaxis but we both know it matters. Cancer doesn’t like happy people. It prefers depressives; it kills them faster.”

“I hear you’re starting a Gene Therapy trial next week?”

“Tomorrow,” said Neef. “I’m optimistic about it. We’re working with a company called, Menogen Research. Their scientific director, a chap called Max Pereira has convinced me it could work.”

“We were all led to believe that about Farro-Jones and Cystic Fibrosis when Uni College tried it out last year,” said MacSween. “But the results were very poor. A pity, I think Farro-Jones might have got a personal chair out of the university if things had gone better but the powers that be were a bit miffed when it didn’t work after all that publicity beforehand.”

“That’s show business,” said Neef. His own comment suddenly made him think of Max Pereira. It was the sort of thing he would have said. “Menogen’s strategy is very different,” he said. “They’re not trying to replace a defective gene like Farro-Jones. They’re introducing a foreign gene which will make tumour cells susceptible to treatment with Gancyclovir.”

“If I were you I would have our Press officer... what’s his name?”

“John Marshall.”

“Aye, Marshall. I’d have him keep the lid on things until you have a success story to tell, otherwise, if it fails, you’ll have the Press back on your doorstep with tales of Dr Michael Mengele, the beast of St George’s using wee sick children as experimental animals.”

“I know the dangers,” said Neef.

“Did you have any trouble getting the trial past the ethics committee?”

“Surprisingly little but I suppose the fact that there’s no human genetic material being exchanged stopped the Frankenstein brigade from getting too upset. The Church didn’t seem to think it was too far away from God’s will and the chairman was positively friendly. The WRVS woman thought for a moment we were going to give everyone Herpes but Pereira managed to put her right. Only David Farro-Jones was a bit cautious but his concern was for patient safety. I suppose he’s a bit hyper-sensitive after his own trial.”

“It’s all new,” said MacSween. “No one knows what to expect and that’s frightening enough in itself. You’re only a hero when things work. Remember the Jenner factor and consider.”

Neef looked puzzled. “Jenner, of vaccination fame?” he asked.

“Precisely,” said MacSween. “Think about what he did. He believed that injecting a little boy with cow pox virus obtained from a milk maid would protect him from smallpox. It did and he became a legendary figure in medicine, a national hero.”

“Yes,” agreed Neef, still puzzled.

“But consider what he actually did. To prove his point he had to inject the child with smallpox... what if his idea hadn’t worked? How would society have viewed that?”

“A diabolical crime,” replied Neef.

“And some of us think it still was,” said MacSween. “But vaccination has succeeded in wiping out smallpox from the face of the earth. A wee moral dilemma wouldn’t you say?”

“Medicine is full of them,” said Neef.

“Well, just remember Mike, if you should be put to the test in the next few weeks, you’ll have a journalist sitting right there in your unit,” said MacSween. “But then, some people keep piranha fish as pets.”

The sound of young Nigel crying put an end to the conversation and the two men made their way back to the house. When they got inside they found Charlie Morse walking up and down with the child on his shoulder. Nigel had stopped crying and was nestling into Charlie’s neck. Charlie was whispering sweet nothings to him.

“He was always good with our two,” said Kate Morse. “It was always Charlie who got up at night.”

“Did you hear that?” Clare jokingly asked her husband. Keith pretended not to hear.

Neef smiled at Eve, realising that talk of babies was isolating the pair of them. She held his gaze for a little longer than necessary and he felt uncomfortable for a moment. As he looked away he wondered why. He concluded it was some kind of vulnerability. His growing attraction to Eve Sayers was making him feel uneasy. But the feeling was oddly pleasant.

Nigel had fallen asleep on Charlie Morse’s shoulder. Morse returned him gently to the Moses basket. He was still whispering to the child as he brought up the covers. Suddenly as he straightened up, he sneezed violently and then again. The second one woke the child, undoing all his good work.

“Bless you Charlie,” murmured Betty. “It sounds like you’ve got a cold coming on.” She lifted the child herself and patted him gently on the back as she soothed him back to sleep. “Granny’s here.”

“It’s time we were starting back anyway,” announced Clare as she got up to take the child from her mother. “It’s been such a nice week-end.”

This was the general signal for everyone to start preparing to leave. Frank and Betty were thanked for their hospitality with genuine enthusiasm. Laughter and good-byes gave way to the sound of car doors being slammed.

“Was that OK?” Neef asked Eve as they joined the main road.

“I had a great time,” said Eve. “They’re a nice couple, especially Betty.”

“I noticed how well you two were getting on,” said Neef. “I think Betty was single-handedly responsible for me not starving to death when I first arrived at St George’s.”

“Where had you come from?” asked Eve.

“The States.”

“I thought you chaps did that thing the other way around,” said Eve. “Aren’t you supposed to go to America in protest against the poor conditions in the National Health Service?”

“That’s usually the way,” agreed Neef. “But personally, I didn’t like America.”

“Why not? You probably earned three times what you get here.”

“I did,” agreed Neef. “And the facilities were the best in the world.”

“So why?”

Neef thought for a moment before saying, “As soon as I started my job in the States I was sent on a course run by the hospital. It was called, Reimbursement Maximization.”

“Doesn’t sound too medical,” said Eve.

“It wasn’t. It was a course designed how to teach the hospital’s doctors how to extract the maximum payment possible from their patients’ health insurance. We were instructed to provide treatment after treatment until all their insurance money was used up and then to continue as long as their families would pay.”

“That sounds awful,” said Eve.

“I’m a children’s’ tumour specialist. Many of my patients weren’t going to get better at all. But the treatment went on until their families in many cases went bankrupt. Do you know that money owed on medical bills is the leading cause of bankruptcy in the United States?”

“I didn’t,” admitted Eve.

“Well, it is and it all got a bit too much for me. Medicine is the second largest industry in the States. It’s big business and somewhere along the line people have lost sight of the fact that money shouldn’t automatically be the first consideration.”

Eve nodded but didn’t say anything.

“And so I came home,” said Neef, “to discover we’ve started out along the same road.”

“The government says not,” said Eve.

Neef snorted his disbelief and brought the Discovery to a halt outside Eve’s apartment block. He turned to smile at her. “I’m sorry; I’ve been shooting my mouth off. I’m really glad you came today. I enjoyed it.”

“Me too,” said Eve, “and I’m glad you told me these things. I like hearing insiders’ views.”

Neef found himself wishing that Eve would ask him in but she didn’t. He hadn’t really had a chance to talk to her properly during the afternoon because of the way things had worked out. As she opened the door to get out she turned and said, “Am I to be allowed to visit Neil?”

“You’ve thought about the conditions we spoke of?”

“Yes. I have and I agree.”

“Then come tomorrow. Make it in the afternoon.”

“Is there anything special he likes?”

“He’s obsessed with fire engines.”

“Fire engines?” exclaimed Eve.

“It’s the only toy we’ve ever managed to interest him in.”

“I’ll see what I can do,” smiled Eve.